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PubMed1998

Erythropoietin in amniotic fluid as a marker of chronic fetal hypoxia.

OBJECTIVE: To determinate the erythropoietin concentration in amniotic fluid in normal pregnancies and pregnancies with suspected hypoxia. METHOD: The erythropoietin concentration of 164 samples of amniotic fluid was determined by ELISA. The samples were taken by amniotomy during birth, as well as amniocentesis conducted during prenatal care. RESULTS: A distribution of 1.07-7.29 U/l (10th-90th percentile) within the normal group (n = 106) was determined. Significantly elevated erythropoietin levels in amniotic fluid were determined in maternal hypertension (P = 0.039) and low birth-weight children (P = 0.0032). A correlation with the child's sex could be excluded. CONCLUSION: Elevated erythropoietin levels in amniotic fluid indicated chronic fetal hypoxia.

Adolescent↗
PubMed1988

Anti HSV-2 properties of amniotic fluid.

Some antiviral properties of amniotic fluid (AF) were studied. A close relationship between maternal blood and AF antiviral antibodies was seen. Substances other than antibodies which could have an effect on viruses were assumed to be present in AF. Using HSV2 as a model, we found a virus-neutralizing activity in 6 out of 7 specimens studied which does not appear to be related to antibodies.

Adult↗
PubMed1975

Furosemide action on the creatinine concentration of amniotic fluid.

Creatinine concentration in the amniotic fluid (A.F.) of pre-eclamptic patients without treatment with furosemide was compared to the values obtained in normal pregnant women at the same stage of gestation. These values increased significantly when a diuretic treatment was started; no correlation was found with either maternal serum level or the A.F. volume. Furosemide treatment had no significant effect on A.F. volume in the pre-eclamptic group.

Amniotic Fluid↗
PubMed1976

Phospholipid concentrations in amniotic fluid from diabetic pregnant women.

Amniotic fluid phospholipid concentrations measured in 104 samples from 65 diabetic patients have been related to gestational age, tevelopment of the respiratory distress syndrome (RDS). There is statistically significant evidence of accelerated surfactant production in White classes D, F, from 34 to 37 weeks gestation. Classes A, B, C, have phospholipid concentrations not significantly different from a reference series. RDS occurred in 26% and was frequently associated with mature phospholipid concentrations. There was a significant correlation between low Apgar scores and subsequent development of RDS.

Amniotic Fluid↗
PubMedDate not supplied

[Clinical condition of the newborns and the type of labor and pregnancy complications in cases of meconium in the amniotic fluid].

The studied material comprised 36 newborns and their mothers, among them 12 newborns had meconium in the amniotic fluid (study group) and 24 newborns with clear amniotic fluid served as controls. The fluids were studied biochemically. In both compared groups the analysed factors were: 1) week of labour, 2) body weight and length, 3) clinical condition of the newborn by the Apgar score, 4) type of labour, 5) type of pregnancy complications in mothers. The results were subjected to statistical analysis. It was found that meconium presence in the amniotic fluid correlated with the presence of clinical symptoms suggesting intrauterine asphyxia of the fetus, and the number of caesarean sections was greater in this group. A correlation was noted between the presence of meconium in the amniotic fluid and worse clinical condition of the newborn.

Amniotic Fluid↗
PubMed1982

Prenatal diagnosis of congenital adrenal hyperplasia due to 21-hydroxylase deficiency by amniotic fluid steroid analysis.

The concentration of 17OH-progesterone was measured in second trimester amniotic fluid samples from 12 mothers who previously had had an infant with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. In 4 affected pregnancies, the concentrations were more than 2 S.D. higher than those determined in 44 samples from normal pregnancies (mean +/- S.D., 8.1 +/- 2.4 nmol/l). The remaining 8 pregnancies were predicted to be unaffected based on the results of amniotic fluid concentrations within the normal range. In each instance, the infant was normal. The results indicate that measurement of amniotic fluid 17OH-progesterone concentrations during the second trimester is an accurate prenatal test for 21-hydroxylase deficiency. The results should be supplemented with determination of fetal sex by karyotype analysis on the amniotic fluid cells.

17-alpha-Hydroxyprogesterone↗
PubMed1997

Fetal origin of amniotic fluid polymorphonuclear leukocytes.

OBJECTIVE: Although polymorphonuclear leukocytes are the inflammatory cells most frequently recovered from the amniotic cavity in cases of suspected intrauterine infection, the source of these cells has not been definitively determined. We took advantage of the gender difference between the mother and her male fetus, and we report four cases in which amniotic fluid polymorphonuclear leukocytes were identified as fetal by fluorescence in situ hybridization with probes specific for X and Y chromosomes. Fetal membranes were intact at the time amniotic fluid was obtained in all cases. STUDY DESIGN: Amniotic fluid was obtained from women with male fetuses in premature labor with clinical or laboratory evidence of infection. Cytospin preparations of amniotic fluid samples with polymorphonuclear leukocytes were prepared and sequentially stained with fluorescent reagents. To determine which cells were polymorphonuclear leukocytes, all replicate samples were stained with the fluorescent nuclear stain 4'-6-diamidino-2-phenyl-indole. This allowed definition of the characteristic multilobed polymorphonuclear leukocytes nuclear morphologic features. The sample was then probed with a rhodamine-labeled probe specific for the X chromosome and a fluorescein-labeled probe specific for the Y chromosome to assess whether the polymorphonuclear leukocytes were male or female. RESULTS: Ninety percent to 99% of polymorphonuclear leukocytes identified by normal multiple lobed nuclear morphologic study on 4'-6-diamidino-2-phenyl-indole staining had an X and Y chromosome and were therefore fetal cells. CONCLUSIONS: These data demonstrate a fetal response during intraamniotic infection. Further investigation of the roles for maternal and fetal polymorphonuclear leukocytes in chorioamnionitis may provide valuable information about the critical interaction of the two immune responses in this setting.

Amniotic Fluid↗
PubMed1986

Fetal renal contribution to amniotic fluid osmolality during maternal hypertonicity.

The contribution of fetal urine to the increase in amniotic fluid osmolality during maternal hypertonicity was studied in chronically catheterized sheep of 130-135 days gestation. Nine percent NaCl was injected simultaneously into fetal and maternal veins, followed by a continuous infusion into the maternal vein. Maternal and fetal plasma osmolalities rose by 15 +/- 1 (SE) and 13 +/- 1 mosmol/kg, respectively, and remained constant for 4 h. Fetal urine osmolality rose significantly from 188 +/- 31 to 277 +/- 32 mosmol/kg within 1 h and remained constant thereafter. Fetal urine flow rose transiently, fell to normal within 10 min, and averaged 70% of normal beyond 1 h. Amniotic fluid osmolality rose by 10.8 +/- 2.8 mosmol/kg over 4 h. Following hypertonic injection into three fetuses blocked by the arginine vasopressin antagonist d(CH2)5D-tyr(Et)VAVP, urine osmolality did not change, and amniotic fluid osmolality rose by 2.7 +/- 0.3 mosmol/kg. Thus it appears that the increase in amniotic fluid osmolality during maternal hypertonicity may be due largely to an increased fetal urine osmolality coupled with a decreased flow of fetal urine into the amniotic space, rather than to bulk flow of fluid across the membranes and uterine wall.

Amniotic Fluid↗
PubMed2004

Mycoplasma hominis in mid-trimester amniotic fluid: relation to pregnancy outcome.

OBJECTIVE: The relationship between detection of Mycoplasma hominis in mid-trimester amniotic fluid and subsequent pregnancy outcome was investigated. STUDY DESIGN: Amniotic fluids from 456 women of European background who underwent a transabdominal amniocentesis at weeks 15-17 of pregnancy were tested for M. hominis by polymerase chain reaction (PCR). The amplicons were hybridized to an internal probe and detected by ELISA. Pregnancy outcomes and clinical data were subsequently obtained. RESULTS: M. hominis were identified in 29 (6.4%) of the amniotic fluids. The rate of preterm labor in women positive for M. hominis (14.3%) was higher than in the negative women (3.3%) (p=0.01). Similarly, a spontaneous preterm birth with intact membranes occurred in 10.7% of the M. hominis-positive women as opposed to only 1.9% of the negative women (p = 0.02). The presence of this mycoplasma was not correlated with fetal chromosomal aberrations, intrauterine growth restriction or preeclampsia. CONCLUSIONS: Detection of M. hominis in second-trimester amniotic fluids can identify women at increased risk for subsequent preterm labor and delivery.

Adult↗
PubMed1999

Correlation between fetal sex and human chorionic gonadotropin in peripheral maternal blood and amniotic fluid in second and third trimester normal pregnancies.

BACKGROUND: To study the correlation between fetal sex and human chorionic gonadotropin (hCG) in maternal blood and amniotic fluid. METHOD AND MATERIAL: One hundred and thirty uncomplicated pregnancies, 82 of whom were at sixteen and 48 at thirty-five weeks of gestation. RESULTS: The hCG levels were significantly higher in maternal serum than in amniotic fluid. At 16 weeks there were no sex-related differences in the hCG levels, either in maternal blood or in amniotic fluid. At 35 weeks the hCG levels in maternal blood were significantly higher in pregnancies with female fetuses than in those carrying male fetuses (p<0.004), while in amniotic fluid the hCG levels tended to be slightly higher in the female group than in the male. In pregnancies with female fetuses the hCG levels in maternal blood were significantly higher at 35 than at 16 weeks (p<0.02), while in pregnancies with male fetuses the levels were highest at 16 weeks. For both sexes the hCG levels in amniotic fluid were significantly higher at 16 than at 35 weeks of pregnancy (p<0.001). Whereas a significant correlation between hCG levels in maternal blood and amniotic fluid was seen at 16 weeks of gestation for both sexes (p<0.01 and R value 0.45 for males and 0.41 for females), no correlation was observed at 35 weeks. CONCLUSION: This study shows a significant correlation between hCG and fetal sex at third trimester of gestation only, possibly caused by a gender factor and a shift in synthesis and/or in metabolism of hCG from the second to the third trimester.

Adult↗
PubMed1977

Accurate photodensitometric measurement of the lecithin: sphingomyelin ration after elimination of the acidic phospholipids from extracts of amniotic fluid specimens.

Treatment of human amniotic fluid lipids dissolved in a chloroform/methanol (9:1, v/v) mixture by batchwise addition of diethylaminoethyl cellulose in a dry state proved to be an easy and rapid procedure for the removal of the acidic phospholipids which may interfere in the photodensitometric evaluation of the lecithin: spingomyelin ratio on a thin-layer chromatogram. This method was used for the measurement of the lecithin: sphingomyelin ratio in a series of normal and abnormal pregnancies. Ratios higher than expected from gestational age were observed in stressed pregnancies. A significant elevation of the ratio was also observed under treatment by dexamethasone.

Amniotic Fluid↗
PubMed1990

Does the color of amniotic fluid still matter?

Second trimester amniotic fluid (AF) is generally clear or very light yellow. We examined the color of 2,141 AF samples. Fifty-six specimens were brown, 35 were green. There were 71 samples with abnormal karyotype (3.46%). In the group with brown AF, there were 7 abnormal karyotypes out of 56 (12.5%). There was 1 case of aneuploidy out of the 35 green samples (2.86%). We conclude that green AF in the second trimester, absent any other findings, carries no special significance, but brown AF carries a fourfold increased incidence of chromosomal aneuploidy in patients undergoing genetic amniocentesis.

Amniotic Fluid↗
PubMed2006

Thrombin activatable fibrinolysis inhibitor (TAFI) in human amniotic fluid. A preliminary study.

Thrombin activatable fibrinolysis inhibitor (TAFI) has been studied in normal and complicated pregnancies by a number of investigators, but there is no information on TAFI in amniotic fluid. In our study we asked two questions: (i) whether TAFI is present in amniotic fluid and in what concentration, (ii) whether its concentration is comparable to that in the blood. The study group consisted of 68 parturient women in the first stage of labour. 20 age-matched non-pregnant women constituted the control group. TAFI antigen was measured by immunoenzymatic method (ELISA) and TAFI activity with Actichrome Plasma TAFI Activity Kit by American Diagnostica. The concentration of TAFI antigen in amniotic fluid was 53.25 ng/ml (median) (range: 44.58-76.20 ng/ml) and in mothers' plasma it was 55.46 ng/ml (median) (range: 39.77-68.54 ng/ml); the difference was not statistically significant (p>0.3388). TAFI activity in amniotic fluid was relatively low (median: 3.00 microg/ml, range 0.50-5.45 microg/ml), while the activity in the mothers' plasma was more than three times higher (median 10.50 microg/ml; range: 7.60-13.50 microg/ml) (p<0.0004). TAFI antigen and TAFI activity in plasma of non-pregnant women were as high as in plasma of delivering women. We have concluded that TAFI is a physiological constituent of amniotic fluid. It is possible that TAFI is partially accountable for the antifibrinolytic potential of amniotic fluid.

Adolescent↗
PubMed1996

Effects of maternal smoking on amniotic fluid volume and fetal urine output.

The purpose of this study was to assess the effects of maternal smoking on amniotic fluid volume and fetal urine output. Seventeen women (10 smokers and 7 non-smokers) were serially assessed through pregnancy. Smoking status was determined by self-report and carbon monoxide manometry. Amniotic fluid volume was assessed by sonographically measuring the maximum vertical pocket, the amniotic fluid index, and the two dimensions of the largest pockets. The coronal area formula was used to calculate bladder volume at 5-minute intervals for 20 minutes. Urine output was calculated from serial measurements of bladder volume. The mean gestational age of the first session was 26.8 (2.7) weeks, of the second session 32.4 (1.6) weeks, and of the last session 36.9 (2.1) weeks. In the univariate analysis there were no differences between smokers and non-smokers at any of the three visits for gestational age, fetal weight, maximum vertical pocket, amniotic fluid index, two-dimensional maximum pocket, and urine output. In the regression model, while controlling for gestational age, smoking status could not predict significant differences in any parameter. Maternal smoking does not appear to affect either amniotic fluid volume or fetal urine output.

Amniotic Fluid↗
PubMed1999

Frigen II improves the reliability of measurement of interleukin-1 related substances in amniotic fluid.

BACKGROUND: To investigate the role of interleukin-1 related substances in amniotic fluid in normal term labor without intrauterine infection. METHODS: Amniotic fluid samples were collected from forty-one patients with various backgrounds. A novel pre-assay treatment using Frigen II was introduced to improve the recovery rates of cytokines, i.e., interleukin-1alpha, interleukin-1beta and interleukin-1 receptor antagonist, prior to ELISA assay. Urine samples from newborn infants were also tested. RESULTS: The concentrations of interleukin-1alpha, interleukin-1beta and interleukin-1ra were significantly higher in samples from normal vaginal delivery. The higher levels of interleukin-1alpha were also observed in samples from preterm labor without infection. Preterm infants produced more of interleukin-1 receptor antagonist in urine compared with term infants. CONCLUSIONS: This study provides evidence of the possible involvement of interleukin-1 related substances in labor without signs of infection. The data from newborn urine suggests that amniotic interleukin-1ra originates from the fetus. However, amniotic fluid interleukin-1alpha and interleukin-1beta may be derived from maternal tissue, such as decidua.

Amniotic Fluid↗
PubMed1983

The effect of fetal pulmonary surfactant production on the apparent microviscosity of amniotic fluid measured by fluorescence polarization.

The fluorescence properties of 1,6 diphenyl 1,3,5-hexatriene (DPH) in human amniotic fluid from the 10--20th week and from the 36--40th week of gestation are investigated. The probe environment of two stages of fetal development are studied by measuring the effect of temperature on the fluorescence polarization of DPH. The temperature profiles of fluorescence polarization of DPH in amniotic fluid and in liposomes prepared from chloroform/methanol extracts of the fluid are compared to the temperature profiles of liposomes prepares from phospholipids of known composition. The DPH binding structures of human amniotic fluid are further characterized by fractionation of lipid bodies by centrifugation on a Ficoll density gradient. The major part of fluorescence in third trimester amniotic fluid is emitted by DPH bound to pulmonary lamellar lipid bodies. The DPH environment in early gestational amniotic fluid is a distinctly different structure, which is more rigid than both sphingomyelin and dipalmityl lecithin at temperatures above 40 degrees C, and which is not chloroform/methanol extractable.

Amniotic Fluid↗
PubMed1982

Quantitative bacteriological analysis of amniotic fluid.

Quantitative bacteriological analysis of amniotic fluid (AF) was performed on 60 fluid samples collected by catheter from 50 selected labor patients regarded as liable to infection. AF cultures were positive in 52 cases. The bacterial colony counts ranged from less than 10(2) colony-forming units (CFU) per milliliter to 10(9) CFU/ml. Pathogenic bacteria in neonates such as group B Streptococcus, Escherichia coli, and Listeria monocytogenes were encountered with numerations equal to or greater than 10(7) CFU/ml in groups with clinical findings. An excellent correlation was noted between bacterial counts in AF and clinical data (p less than 0.00006). The results confirm that the quantitative bacteria analysis of the AF is a useful tool for evaluation of an infection risk for neonates.

Amniotic Fluid↗
PubMedDate not supplied

Effects on the maternofetal unit of the rabbit model after substitution of the amniotic fluid with perfluorocarbons.

OBJECTIVES: Exchanging amniotic fluid (AF) with perfluorocarbon (PFC) may serve as a medium for fetoscopic surgery. This study evaluates the distribution and physiologic effects of intraamniotic PFC as a medium for fetoscopy. METHODS: Fetuses of 17 pregnant rabbits underwent either exchange of the AF with PFC, electrolyte solution (ES), or control. The quality of vision during fetoscopy was assessed in AF and PFC. After 6 h, we determined the distribution of PFC in the maternofetal unit. RESULTS: Quality of vision during fetoscopy was better in PFC than with AF. There was no difference in fetal survival between the study groups. PFC was demonstrated on X-ray in the pharynx of 4 fetuses, and the esophagus in 1. CONCLUSIONS: PFC provided an ideal medium for fetoscopy without fetal compromise.

Amniotic Fluid↗